A simple method of conjunctival dissection for Gunderson flaps

L. J. Maguire and D. R. Shearer
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905.

In this study we describe a method for simplifying the often frustrating and time-consuming task of dissecting conjunctiva from underlying Tenon's capsule during Gunderson flap procedures. Using gentian violet marks as a guide, a needle and two pairs of scissors are used in series to separate superior bulbar conjunctiva from the superficial layers of Tenon's capsule along a series of semimeridians. The techniques provides the surgeon with important landmarks, reduces the risk of inadvertent buttonholing, and minimizes conjunctival retraction caused by uneven dissection of Tenon's capsule.